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Diagnostics
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Hyperglycemia in Respiratory Diseases—Impact and Challenges
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Hyperglycemia in Respiratory Diseases—Impact and Challenges

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 10483

Special Issue Editor

Prof. Dr. Semra Bilaceroglu

E-Mail Website
Guest Editor
Department of Pulmonary Medicine, Izmir Dr Suat Seren Training and Research Hospital for Thoracic Medicine and Surgery, University of Health Sciences-Turkey, Izmir, Turkey
Interests: interventional pulmonology; pleural diseases; sarcoidosis and other granulomatous diseases; lung cancer; pulmonary vascular diseases

Special Issue Information

Dear Colleagues,

Hyperglycemia (increased blood glucose levels) has become an epidemic disorder worldwide. As it affects multiple organs, hyperglycemia-related complications need to be continuously followed-up and assessed. Macrovascular and microvascular diseases due to hyperglycemia lead to morbidity and mortality, contribute adversely to the quality of life and increase the cost of health care. The respiratory system is one of the most overlooked target organs of hyperglycemia because its clinical relevance is underrecognized and the hyperglycemia–respiratory system association has not been investigated sufficiently. Respiratory diseases, also increasing in prevalence globally, have a bidirectional relationship with hyperglycemia. The pro-inflammatory, proliferative, and oxidative properties of hyperglycemia have been shown to have a significant role in affecting pulmonary vasculature, airways, and lung parenchyma. Although the relevant data suggests some overlapping or shared regulatory mechanisms between hyperglycemia and respiratory diseases, their exact relationships have not yet been shown clearly. Elucidating how hyperglycemia and respiratory diseases impact each other will be beneficial in developing new management strategies. Thus, this Special Issue will focus on the adverse association between hyperglycemia and respiratory diseases, and its clinical impacts and challenges regarding management.

Prof. Dr. Semra Bilaceroglu
Guest Editor

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Published Papers (6 papers)

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Review

12 pages, 261 KiB  
Review
The Complex Relationship Between Tuberculosis and Hyperglycemia
by Michelle Byers and Elizabeth Guy
Diagnostics 2024, 14(22), 2539; https://doi.org/10.3390/diagnostics14222539 - 13 Nov 2024
Viewed by 402
Abstract
Hyperglycemia and tuberculosis are dual global pandemics. Each has a propulsive and amplifying effect on the other, and, because of this, we must consider hyperglycemia and tuberculosis together. Hyperglycemia is immunosuppressive and increases the risk of tuberculosis by threefold. It also leads to [...] Read more.
Hyperglycemia and tuberculosis are dual global pandemics. Each has a propulsive and amplifying effect on the other, and, because of this, we must consider hyperglycemia and tuberculosis together. Hyperglycemia is immunosuppressive and increases the risk of tuberculosis by threefold. It also leads to a more advanced presentation of pulmonary tuberculosis, thus increasing the likelihood of being smear positive and having cavitating lesions, and it impacts the duration and outcomes of treatment, with an increased one year mortality seen in patients with tuberculosis and diabetes. Additionally, any degree of hyperglycemia can have an impact on susceptibility to tuberculosis, and this effect is not limited to poorly controlled diabetes. Conversely, tuberculosis itself is associated with hyperglycemia and worsens hyperglycemia in those with diabetes mellitus. The impact of this relationship varies based on the base rates of each disease in different regions of the world. In order to successfully achieve the World Health Organization’s goals of tuberculosis eradication and adequate glycemic control, we must improve our understanding, co-management, and screening of hyperglycemia and tuberculosis. This review aims to explore the current research investigating the relationship between tuberculosis and diabetes, including the changes in disease susceptibility, presentation, geographic distribution, and effects on treatment. Full article
(This article belongs to the Special Issue Hyperglycemia in Respiratory Diseases—Impact and Challenges)
12 pages, 1377 KiB  
Review
Hyperglycemia and Venous Thromboembolism
by Neha Panchagnula and William Philip Brasher
Diagnostics 2024, 14(17), 1994; https://doi.org/10.3390/diagnostics14171994 - 9 Sep 2024
Viewed by 831
Abstract
Patients with diabetes mellitus (DM) have chronically increased blood glucose and multiple physiologic alterations that place them at elevated risk for vascular disease. Traditionally, this vascular risk has mainly referred to chronic atherosclerosis and embolic arterial disease. Retrospective studies have suggested an increased [...] Read more.
Patients with diabetes mellitus (DM) have chronically increased blood glucose and multiple physiologic alterations that place them at elevated risk for vascular disease. Traditionally, this vascular risk has mainly referred to chronic atherosclerosis and embolic arterial disease. Retrospective studies have suggested an increased risk of a pulmonary embolism (PE) and deep vein thrombosis (DVT), collectively termed venous thromboembolism (VTE), in patients with DM, but this association has been difficult to demonstrate with comorbidities such as obesity in meta-analysis. Clinical studies have demonstrated worse outcomes for patients with DM who suffer from VTE. In vitro studies show multiple physiologic abnormalities with chronic inflammation, endothelial dysfunction, dysfunction in the coagulation cascade, as well as other changes that drive a vicious cycle of hypercoagulability. Aggressive medical management of DM can improve vascular outcomes, and some anti-hyperglycemic therapies may modify VTE risk as well. Anticoagulation strategies are similar for patients with DM, but with some added considerations, such as high rates of comorbid renal dysfunction. More research is needed to definitively categorize DM as a risk factor for VTE and elucidate specific therapeutic strategies. Full article
(This article belongs to the Special Issue Hyperglycemia in Respiratory Diseases—Impact and Challenges)
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12 pages, 1001 KiB  
Review
Asthma and Hyperglycemia: Exploring the Interconnected Pathways
by Dharani K. Narendra and Sandhya Khurana
Diagnostics 2024, 14(17), 1869; https://doi.org/10.3390/diagnostics14171869 - 26 Aug 2024
Viewed by 1107
Abstract
The interplay between asthma and glucose metabolism disorders, such as hyperglycemia, has gained increasing attention due to the potential exacerbation of asthma symptoms and severity. This review explores the complex relationship between hyperglycemia and asthma, emphasizing the pathophysiological links, the impact of glucose [...] Read more.
The interplay between asthma and glucose metabolism disorders, such as hyperglycemia, has gained increasing attention due to the potential exacerbation of asthma symptoms and severity. This review explores the complex relationship between hyperglycemia and asthma, emphasizing the pathophysiological links, the impact of glucose metabolism disorders on asthma, and the effects of asthma medications on glucose levels. Hyperglycemia, often induced by asthma treatments like corticosteroids, has been associated with an increased risk of asthma exacerbations. This review delves into the pathophysiology underlying this association, highlighting the role of insulin resistance, metabolic syndrome, and obesity in both the development and management of asthma. Metabolic syndrome, characterized by abdominal obesity and hyperglycemia, independently increases the risk of worsening respiratory symptoms and asthma. Furthermore, this review examines the influence of various antidiabetic medications on asthma outcomes. Biguanides, like metformin, have shown promise in improving asthma outcomes in patients with type 2 diabetes mellitus and asthma. However, other medications have mixed results regarding their impact on asthma control and lung function. Considering these findings, this review advocates for further research into the role of metabolic pathways in asthma management. It calls for comparative studies and the inclusion of asthma-related outcomes in clinical trials of antidiabetic drugs to better understand their potential benefits for individuals with obesity and concurrent asthma. Full article
(This article belongs to the Special Issue Hyperglycemia in Respiratory Diseases—Impact and Challenges)
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12 pages, 505 KiB  
Review
Pulmonary Hypertension and Hyperglycemia—Not a Sweet Combination
by Or Bruck and L. M. Pandit
Diagnostics 2024, 14(11), 1119; https://doi.org/10.3390/diagnostics14111119 - 28 May 2024
Viewed by 1393
Abstract
Hyperglycemia and pulmonary hypertension (PH) share common pathological pathways that lead to vascular dysfunction and resultant cardiovascular complications. These shared pathologic pathways involve endothelial dysfunction, inflammation, oxidative stress, and hormonal imbalances. Individuals with hyperglycemia or pulmonary hypertension also possess shared clinical factors that [...] Read more.
Hyperglycemia and pulmonary hypertension (PH) share common pathological pathways that lead to vascular dysfunction and resultant cardiovascular complications. These shared pathologic pathways involve endothelial dysfunction, inflammation, oxidative stress, and hormonal imbalances. Individuals with hyperglycemia or pulmonary hypertension also possess shared clinical factors that contribute to increased morbidity from both diseases. This review aims to explore the relationship between PH and hyperglycemia, highlighting the mechanisms underlying their association and discussing the clinical implications. Understanding these common pathologic and clinical factors will enable early detection for those at-risk for complications from both diseases, paving the way for improved research and targeted therapeutics. Full article
(This article belongs to the Special Issue Hyperglycemia in Respiratory Diseases—Impact and Challenges)
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14 pages, 3776 KiB  
Review
Diabetes Mellitus and Pneumococcal Pneumonia
by Catia Cilloniz and Antoni Torres
Diagnostics 2024, 14(8), 859; https://doi.org/10.3390/diagnostics14080859 - 22 Apr 2024
Cited by 1 | Viewed by 2613
Abstract
Currently, there are more than 500 million people suffering from diabetes around the world. People aged 65 years or older are the most affected by this disease, and it is estimated that approximately 96% of diabetes cases worldwide are type 2 diabetes. People [...] Read more.
Currently, there are more than 500 million people suffering from diabetes around the world. People aged 65 years or older are the most affected by this disease, and it is estimated that approximately 96% of diabetes cases worldwide are type 2 diabetes. People with diabetes mellitus are at an increased risk of infections such as pneumonia, due to a series of factors that may contribute to immune dysfunction, including hyperglycemia, inhibition of neutrophil chemotaxis, impaired cytokine production, phagocytic cell dysfunction, altered T cell-mediated immune responses and the co-existence of chronic comorbidities. Rates of infection, hospitalization and mortality in diabetic patients are reported to be higher than in the general population. Research into the risk of infectious diseases such as pneumonia in these patients is very important because it will help improve their management and treatment. Full article
(This article belongs to the Special Issue Hyperglycemia in Respiratory Diseases—Impact and Challenges)
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13 pages, 314 KiB  
Review
Hyperglycaemia and Chronic Obstructive Pulmonary Disease
by Mario Cazzola, Paola Rogliani, Josuel Ora, Luigino Calzetta, Davide Lauro and Maria Gabriella Matera
Diagnostics 2023, 13(21), 3362; https://doi.org/10.3390/diagnostics13213362 - 1 Nov 2023
Cited by 2 | Viewed by 3235
Abstract
Chronic obstructive pulmonary disease (COPD) may coexist with type 2 diabetes mellitus (T2DM). Patients with COPD have an increased risk of developing T2DM compared with a control but, on the other side, hyperglycaemia and DM have been associated with reduced predicted levels of [...] Read more.
Chronic obstructive pulmonary disease (COPD) may coexist with type 2 diabetes mellitus (T2DM). Patients with COPD have an increased risk of developing T2DM compared with a control but, on the other side, hyperglycaemia and DM have been associated with reduced predicted levels of lung function. The mechanistic relationships between these two diseases are complicated, multifaceted, and little understood, yet they can impact treatment strategy. The potential risks and benefits for patients with T2DM treated with pulmonary drugs and the potential pulmonary risks and benefits for patients with COPD when taking antidiabetic drugs should always be considered. The interaction between the presence and/or treatment of COPD, risk of infection, presence and/or treatment of T2DM and risk of acute exacerbations of COPD (AECOPDs) can be represented as a vicious circle; however, several strategies may help to break this circle. The most effective approach to simultaneously treating T2DM and COPD is to interfere with the shared inflammatory substrate, thus targeting both lung inflammation (COPD) and vascular inflammation (DM). In any case, it is always crucial to establish glycaemic management since the reduction in lung function found in people with diabetes might decrease the threshold for clinical manifestations of COPD. In this article, we examine possible connections between COPD and T2DM as well as pharmacological strategies that could focus on these connections. Full article
(This article belongs to the Special Issue Hyperglycemia in Respiratory Diseases—Impact and Challenges)
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